Search results for: single tooth restoration
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5102

Search results for: single tooth restoration

4202 Larger Diameter 22 MM-PDC Cutter Greatly Improves Drilling Efficiency of PDC Bit

Authors: Fangyuan Shao, Wei Liu, Deli Gao

Abstract:

With the increasing speed of oil and gas exploration, development and production at home and abroad, the demand for drilling speed up technology is becoming more and more critical to reduce the development cost. Highly efficient and personalized PDC bit is important equipment in the bottom hole assembly (BHA). Therefore, improving the rock-breaking efficiency of PDC bits will help reduce drilling time and drilling cost. Advances in PDC bit technology have resulted in a leapfrogging improvement in the rate of penetration (ROP) of PDC bits over roller cone bits in soft to medium-hard formations. Recently, with the development of PDC technology, the diameter of the PDC tooth can be further expanded. The maximum diameter of the PDC cutter used in this paper is 22 mm. According to the theoretical calculation, under the same depth of cut (DOC), the 22mm-PDC cutter increases the exposure of the cutter, and the increase of PDC cutter diameter helps to increase the cutting area of the PDC cutter. In order to evaluate the cutting performance of the 22 mm-PDC cutter and the existing commonly used cutters, the 16 mm, 19 mm and 22 mm PDC cutter was selected put on a vertical turret lathe (VTL) in the laboratory for cutting tests under different DOCs. The DOCs were 0.5mm, 1.0 mm, 1.5 mm and 2.0 mm, 2.5 mm and 3 mm, respectively. The rock sample used in the experiment was limestone. Results of laboratory tests have shown the new 22 mm-PDC cutter technology greatly improved cutting efficiency. On the one hand, as the DOC increases, the mechanical specific energy (MSE) of all cutters decreases, which means that the cutting efficiency increases. On the other hand, under the same DOC condition, the larger the cutter diameter is, the larger the working area of the cutter is, which leads to higher the cutting efficiency. In view of the high performance of the 22 mm-PDC cutters, which was applied to carry out full-scale bit field experiments. The result shows that the bit with 22mm-PDC cutters achieves a breakthrough improvement of ROP than that with conventional 16mm and 19mm cutters in offset well drilling.

Keywords: polycrystalline diamond compact, 22 mm-PDC cutters, cutting efficiency, mechanical specific energy

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4201 Ecosystem Restoration: Remediation of Crude Oil-Polluted Soil by Leuceana leucocephala (Lam.) de Wit

Authors: Ayodele Adelusi Oyedeji

Abstract:

The study was carried out under a controlled environment with the aim of examining remediation of crude oil polluted soil. The germination rate, heights and girths, number of leaves and nodulation was determined following standard procedures. Some physicochemical (organic matter, pH, nitrogen, phosphorous, potassium, calcium, magnesium and sodium) characteristics of soil used were determined using standard protocols. Results showed that at varying concentration of crude oil i.e 0 ml, 25 ml, 50 ml, 75 ml and 100 ml, Leuceana leucocephala had germination rate of 92%, 90%, 84%, 62% and 56% respectively, mean height of 73.70cm, 58.30cm, 49.50cm, 46.45cm and 41.80cm respectively after 16 weeks after planting (WAP), mean girth of 0.54mm, 0.34mm, 0.33mm, 0.21mm and 0.19mm respectively at 16 WAP, number of nodules 18, 10, 10, 6 and 2 respectively and number of leaves 24.00, 16.00, 13.00, 10.00 and 6.00 respectively. The organic matter, pH, nitrogen, phosphorous, potassium, calcium, magnesium, and sodium decreased with the increase in the concentration of crude oil. Furthermore, as the concentration of crude oil increased the germination rate, height, girth, and number of leaves and nodules decreased, suggesting the effect of crude oil on Leuceana leucocephala. The plant withstands the varying concentration of the crude oil means that it could be used for the remediation of crude oil contaminated soil in the Niger Delta region of Nigeria.

Keywords: ecosystem conservation, Leuceana leucocephala, phytoremediation, soil pollution

Procedia PDF Downloads 109
4200 Micromechanical Compatibility Between Cells and Scaffold Mediates the Efficacy of Regenerative Medicine

Authors: Li Yang, Yang Song, Martin Y. M. Chiang

Abstract:

Objective: To experimentally substantiate the micromechanical compatibility between cell and scaffold, in the regenerative medicine approach for restoring bone volume, is essential for phenotypic transitions Methods: Through nanotechnology and electrospinning process, nanofibrous scaffolds were fabricated to host dental follicle stem cells (DFSCs). Blends (50:50) of polycaprolactone (PCL) and silk fibroin (SF), mixed with various content of cellulose nanocrystals (CNC, up to 5% in weight), were electrospun to prepare nanofibrous scaffolds with heterogeneous microstructure in terms of fiber size. Colloidal probe atomic force microscopy (AFM) and conventional uniaxial tensile tests measured the scaffold stiffness at the micro-and macro-scale, respectively. The cell elastic modulus and cell-scaffold adhesive interaction (i.e., a chemical function) were examined through single-cell force spectroscopy using AFM. The quantitative reverse transcription-polymerase chain reaction (qRT-PCR) was used to determine if the mechanotransduction signal (i.e., Yap1, Wwr2, Rac1, MAPK8, Ptk2 and Wnt5a) is upregulated by the scaffold stiffness at the micro-scale (cellular scale). Results: The presence of CNC produces fibrous scaffolds with a bimodal distribution of fiber diameter. This structural heterogeneity, which is CNC-composition dependent, remarkably modulates the mechanical functionality of scaffolds at microscale and macroscale simultaneously, but not the chemical functionality (i.e., only a single material property is varied). In in vitro tests, the osteogenic differentiation and gene expression associated with mechano-sensitive cell markers correlate to the degree of micromechanical compatibility between DFSCs and the scaffold. Conclusion: Cells require compliant scaffolds to encourage energetically favorable interactions for mechanotransduction, which are converted into changes in cellular biochemistry to direct the phenotypic evolution. The micromechanical compatibility is indeed important to the efficacy of regenerative medicine.

Keywords: phenotype transition, scaffold stiffness, electrospinning, cellulose nanocrystals, single-cell force spectroscopy

Procedia PDF Downloads 190
4199 Effect of Hydrogen-Diesel Dual Fuel Combustion on the Performance and Emission Characteristics of a Four Stroke-Single Cylinder Diesel Engine

Authors: Madhujit Deb, G. R. K. Sastry, R. S. Panua, Rahul Banerjee, P. K. Bose

Abstract:

The present work attempts to investigate the combustion, performance and emission characteristics of an existing single-cylinder four-stroke compression-ignition engine operated in dual-fuel mode with hydrogen as an alternative fuel. Environmental concerns and limited amount of petroleum fuels have caused interests in the development of alternative fuels like hydrogen for internal combustion (IC) engines. In this experimental investigation, a diesel engine is made to run using hydrogen in dual fuel mode with diesel, where hydrogen is introduced into the intake manifold using an LPG-CNG injector and pilot diesel is injected using diesel injectors. A Timed Manifold Injection (TMI) system has been developed to vary the injection strategies. The optimized timing for the injection of hydrogen was 100 CA after top dead center (ATDC). From the study it was observed that with increasing hydrogen rate, enhancement in brake thermal efficiency (BTHE) of the engine has been observed with reduction in brake specific energy consumption (BSEC). Furthermore, Soot contents decrease with an increase in indicated specific NOx emissions with the enhancement of hydrogen flow rate.

Keywords: diesel engine, hydrogen, BTHE, BSEC, soot, NOx

Procedia PDF Downloads 538
4198 Analysis of Replication Protein A (RPA): The Role of Homolog Interaction and Recombination during Meiosis

Authors: Jeong Hwan Joo, Keun Pil Kim

Abstract:

During meiosis, meiotic recombination is initiated by Spo11-mediated DSB formation and exonuclease-mediated DSB resection occurs to expose single stranded DNA formation. RPA is further required to inhibit secondary structure formation of ssDNA that can be formed Watson-Crick pairing. Rad51-Dmc1, RecA homologs in eukaryote and their accessory factors involve in searching homolog templates to mediate strand exchange. In this study, we investigate the recombinational roles of replication protein A (RPA), which is heterotrimeric protein that is composed of RPA1, RPA2, and RPA3. Here, we investigated meiotic recombination using DNA physical analysis at the HIS4LEU2 hot spot. In rfa1-119 (K45E, N316S) cells, crossover (CO) and non-crossover (NCO) products reduced than WT. rfa1-119 delayed in single end invasion-to-double holiday junction (SEI-to-dHJ) transition and exhibits a defect in second-end capture that is also modulated by Rad52. In the further experiment, we observed that in rfa1-119 mutant, RPA could not be released in timely manner. Furthermore, rfa1-119 exhibits failure in the second end capture, implying reduction of COs and NCOs. In this talk, we will discuss more detail how RPA involves in chromatin axis association via formation of axis-bridge and why RPA is required for Rad52-mediated second-end capture progression.

Keywords: homolog interaction, meiotic recombination, replication protein A, RPA1

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4197 Different Tools and Complex Approach for Improving Phytoremediation Technology

Authors: T. Varazi, M. Pruidze, M. Kurashvili, N. Gagelidze, M. Sutton

Abstract:

The complex phytoremediation approach given in the presented work implies joint application of natural sorbents, microorganisms, natural biosurfactants and plants. The approach is based on using the natural mineral composites, microorganism strains with high detoxification abilities, plants-phytoremediators and natural biosurfactants for enhancing the uptake of intermediates of pollutants by plant roots. In this complex strategy of phytoremediation technology, the sorbent serves to uptake and trap the pollutants and thus restrain their emission in the environment. The role of microorganisms is to accomplish the first stage biodegradation of organic contaminants. This is followed by application of a phytoremediation technology through purposeful planting of selected plants. Thus, using of different tools will provide restoration of polluted environment and prevention of toxic compounds’ dissemination from hotbeds of pollution for a considerable length of time. The main idea and novelty of the carried out work is the development of a new approach for the ecological safety. The wide spectrum of contaminants: Organochlorine pesticide – DDT, heavy metal –Cu, oil hydrocarbon (hexadecane) and wax have been used in this work. The presented complex biotechnology is important from the viewpoint of prevention, providing total rehabilitation of soil. It is unique to chemical pollutants, ecologically friendly and provides the control of erosion of soils.

Keywords: bioremediation, phytoremediation, pollutants, soil contamination

Procedia PDF Downloads 297
4196 Development of a Complete Single Jet Common Rail Injection System Gas Dynamic Model for Hydrogen Fueled Engine with Port Injection Feeding System

Authors: Mohammed Kamil, M. M. Rahman, Rosli A. Bakar

Abstract:

Modeling of hydrogen fueled engine (H2ICE) injection system is a very important tool that can be used for explaining or predicting the effect of advanced injection strategies on combustion and emissions. In this paper, a common rail injection system (CRIS) is proposed for 4-strokes 4-cylinders hydrogen fueled engine with port injection feeding system (PIH2ICE). For this system, a numerical one-dimensional gas dynamic model is developed considering single injection event for each injector per a cycle. One-dimensional flow equations in conservation form are used to simulate wave propagation phenomenon throughout the CR (accumulator). Using this model, the effect of common rail on the injection system characteristics is clarified. These characteristics include: rail pressure, sound velocity, rail mass flow rate, injected mass flow rate and pressure drop across injectors. The interaction effects of operational conditions (engine speed and rail pressure) and geometrical features (injector hole diameter) are illustrated; and the required compromised solutions are highlighted. The CRIS is shown to be a promising enhancement for PIH2ICE.

Keywords: common rail, hydrogen engine, port injection, wave propagation

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4195 Redesigning Clinical and Nursing Informatics Capstones

Authors: Sue S. Feldman

Abstract:

As clinical and nursing informatics mature, an area that has gotten a lot of attention is the value capstone projects. Capstones are meant to address authentic and complex domain-specific problems. While capstone projects have not always been essential in graduate clinical and nursing informatics education, employers are wanting to see evidence of the prospective employee's knowledge and skills as an indication of employability. Capstones can be organized in many ways: a single course over a single semester, multiple courses over multiple semesters, as a targeted demonstration of skills, as a synthesis of prior knowledge and skills, mentored by one single person or mentored by various people, submitted as an assignment or presented in front of a panel. Because of the potential for capstones to enhance the educational experience, and as a mechanism for application of knowledge and demonstration of skills, a rigorous capstone can accelerate a graduate's potential in the workforce. In 2016, the capstone at the University of Alabama at Birmingham (UAB) could feel the external forces of a maturing Clinical and Nursing Informatics discipline. While the program had a capstone course for many years, it was lacking the depth of knowledge and demonstration of skills being asked for by those hiring in a maturing Informatics field. Since the program is online, all capstones were always in the online environment. While this modality did not change, other contributors to instruction modality changed. Pre-2016, the instruction modality was self-guided. Students checked in with a single instructor, and that instructor monitored progress across all capstones toward a PowerPoint and written paper deliverable. At the time, the enrollment was few, and the maturity had not yet pushed hard enough. By 2017, doubling enrollment and the increased demand of a more rigorously trained workforce led to restructuring the capstone so that graduates would have and retain the skills learned in the capstone process. There were three major changes: the capstone was broken up into a 3-course sequence (meaning it lasted about 10 months instead of 14 weeks), there were many chunks of deliverables, and each faculty had a cadre of about 5 students to advise through the capstone process. Literature suggests that the chunking, breaking up complex projects (i.e., the capstone in one summer) into smaller, more manageable chunks (i.e., chunks of the capstone across 3 semesters), can increase and sustain learning while allowing for increased rigor. By doing this, the teaching responsibility was shared across faculty with each semester course being taught by a different faculty member. This change facilitated delving much deeper in instruction and produced a significantly more rigorous final deliverable. Having students advised across the faculty seemed like the right thing to do. It not only shared the load, but also shared the success of students. Furthermore, it meant that students could be placed with an academic advisor who had expertise in their capstone area, further increasing the rigor of the entire capstone process and project and increasing student knowledge and skills.

Keywords: capstones, clinical informatics, health informatics, informatics

Procedia PDF Downloads 133
4194 Comparison of High Speed Railway Bride Foundation Design

Authors: Hussein Yousif Aziz

Abstract:

This paper discussed the design and analysis of bridge foundation subjected to load of train with three codes, namely AASHTO code, British Standard BS Code 8004 (1986), and Chinese code (TB10002.5-2005).The study focused on the design and analysis of bridge’s foundation manually with the three codes and found which code is better for design and controls the problem of high settlement due to the applied loads. The results showed the Chinese codes are costly that the number of reinforcement bars in the pile cap and piles is more than those with AASHTO code and BS code with the same dimensions. Settlement of the bridge was calculated depending on the data collected from the project site. The vertical ultimate bearing capacity of single pile for three codes is also discussed. Other analyses by using the two-dimensional Plaxis program and other programs like SAP2000 14, PROKON many parameters are calculated. The maximum values of the vertical displacement are close to the calculated ones. The results indicate that the AASHTO code is economics and safer in the bearing capacity of single pile. The purpose of this project is to study out the pier on the basis of the design of the pile foundation. There is a 32m simply supported beam of box section on top of the structure. The pier of bridge is round-type. The main component of the design is to calculate pile foundation and the settlement. According to the related data, we choose 1.0m in diameter bored pile of 48m. The pile is laid out in the rectangular pile cap. The dimension of the cap is 12m 9 m. Because of the interaction factors of pile groups, the load-bearing capacity of simple pile must be checked, the punching resistance of pile cap, the shearing strength of pile cap, and the part in bending of pile cap, all of them are very important to the structure stability. Also, checking soft sub-bearing capacity is necessary under the pile foundation. This project provides a deeper analysis and comparison about pile foundation design schemes. Firstly, here are brief instructions of the construction situation about the Bridge. With the actual construction geological features and the upper load on the Bridge, this paper analyzes the bearing capacity and settlement of single pile. In the paper the Equivalent Pier Method is used to calculate and analyze settlements of the piles.

Keywords: pile foundation, settlement, bearing capacity, civil engineering

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4193 Studies of Single Nucleotide Polymorphism of Proteosomal Gene Complex and Their Association with HBV Infection Risk in India

Authors: Jasbir Singh, Devender Kumar, Davender Redhu, Surender Kumar, Vandana Bhardwaj

Abstract:

Single Nucleotide polymorphism (SNP) of proteosomal gene complex is involved in the pathogenesis of hepatitis B Virus (HBV) infection. Some of such proteosomal gene complex are large multifunctional proteins (LMP) and antigen associated transporters that help in antigen presentation. Both are involved in intracellular processing and presentation of viral antigens in association with Major Histocompatability Complex (MHC) Class I molecules. A total of hundred each of hepatitis B virus infected and control samples from northern India were studied. Genomic DNA was extracted from all studied samples and PCR-RFLP method was used for genotyping at different positions of LMP genes. Genotypes at a given position were inferred from the pattern of bands and genotype frequencies and haplotype frequencies were also calculated. Homozygous SNP {A>C} was observed at codon 145 of LMP7 gene and having a protective role against HBV as there was statistically significant high distribution of this SNP among controls than cases. Heterozygous SNP {A>C} was observed at codon 145 of LMP7 gene and made individuals more susceptible to HBV infection as there was statistically significant high distribution of this SNP among cases than control. SNP {T>C} was observed at codon 60 of LMP2 gene but statistically significant differences were not observed among controls and cases. For codon 145 of LMP7 and codon 60 of LMP2 genes, four haplotypes were constructed. Haplotype I (LMP2 ‘C’ and LMP7 ‘A’) made individuals carrying it more susceptible to HBV infection as there was statistically significant high distribution of this haplotype among cases than control. Haplotype II (LMP2 ‘C’ and LMP7 ‘C’) made individuals carrying it more immune to HBV infection as there was statistically significant high distribution of this haplotype among control than cases. Thus it can be concluded that homozygous SNP {A>C} at codon 145 of LMP7 and Haplotype II (LMP2 ‘C’ and LMP7 ‘C’) has a protective role against HBV infection whereas heterozygous SNP {A>C} at codon 145 of LMP7 and Haplotype I (LMP2 ‘C’ and LMP7 ‘A’) made individuals more susceptible to HBV infection.

Keywords: Hepatitis B Virus, single nucleotide polymorphism, low molecular weight proteins, transporters associated with antigen presentation

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4192 Comparative Evaluation of Ultrasound Guided Internal Jugular Vein Cannulation Using Measured Guided Needle and Conventional Size Needle for Success and Complication of Cannulation

Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

Abstract:

Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

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4191 Investigation of the Thermal Flow inside the Catalytic Combustor for Lean CH4-Air Mixture on a Platinum Catalyst with H2 Addition

Authors: Kumaresh Selvakumar, Man Young Kim

Abstract:

In order to elaborate the main idea of investigating the flow physics inside the catalytic combustor, the characteristics of the catalytic surface reactions are analyzed by employing the CHEMKIN methodology with detailed gas and surface chemistries. The presence of a catalyst inside an engine enables complete combustion at lower temperatures which promotes desired chemical reactions. A single channel from the honeycomb monolith catalytic combustor is preferred to analyze the gas and surface reactions in the catalyst bed considering the fact that every channel in the honeycomb monolith behaves in similar fashion. The simplified approach with single catalyst channel using plug flow reactor can be used to predict the flow behavior inside the catalytic combustor. The hydrogen addition to the combustion reactants offers a way to light-off catalytic combustion of methane on platinum catalyst and aids to reduce the surface ignition temperature. Indeed, the hydrogen adsorption is higher on the uncovered Pt(s) surface sites because the sticking coefficient of hydrogen is larger than that of methane. The location of flame position in the catalyst bed is validated by igniting the methane fuel with the presence of hydrogen for corresponding multistep surface reactions.

Keywords: catalytic combustor, hydrogen adsorption, plug flow reactor, surface ignition temperature

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4190 Vibration Control of Building Using Multiple Tuned Mass Dampers Considering Real Earthquake Time History

Authors: Rama Debbarma, Debanjan Das

Abstract:

The performance of multiple tuned mass dampers to mitigate the seismic vibration of structures considering real time history data is investigated in this paper. Three different real earthquake time history data like Kobe, Imperial Valley and Mammoth Lake are taken in the present study. The multiple tuned mass dampers (MTMD) are distributed at each storey. For comparative study, single tuned mass damper (STMD) is installed at top of the similar structure. This study is conducted for a fixed mass ratio (5%) and fixed damping ratio (5%) of structures. Numerical study is performed to evaluate the effectiveness of MTMDs and overall system performance. The displacement, acceleration, base shear and storey drift are obtained for both combined system (structure with MTMD and structure with STMD) for all earthquakes. The same responses are also obtained for structure without damper system. From obtained results, it is investigated that the MTMD configuration is more effective for controlling the seismic response of the primary system with compare to STMD configuration.

Keywords: Earthquake, multiple tuned mass dampers, single tuned mass damper, Time history.

Procedia PDF Downloads 270
4189 Future of Nanotechnology in Digital MacDraw

Authors: Pejman Hosseinioun, Abolghasem Ghasempour, Elham Gholami, Hamed Sarbazi

Abstract:

Considering the development in global semiconductor technology, it is anticipated that gadgets such as diodes and resonant transistor tunnels (RTD/RTT), Single electron transistors (SET) and quantum cellular automata (QCA) will substitute CMOS (Complementary Metallic Oxide Semiconductor) gadgets in many applications. Unfortunately, these new technologies cannot disembark the common Boolean logic efficiently and are only appropriate for liminal logic. Therefor there is no doubt that with the development of these new gadgets it is necessary to find new MacDraw technologies which are compatible with them. Resonant transistor tunnels (RTD/RTT) and circuit MacDraw with enhanced computing abilities are candida for accumulating Nano criterion in the future. Quantum cellular automata (QCA) are also advent Nano technological gadgets for electrical circuits. Advantages of these gadgets such as higher speed, smaller dimensions, and lower consumption loss are of great consideration. QCA are basic gadgets in manufacturing gates, fuses and memories. Regarding the complex Nano criterion physical entity, circuit designers can focus on logical and constructional design to decrease complication in MacDraw. Moreover Single electron technology (SET) is another noteworthy gadget considered in Nano technology. This article is a survey in future of Nano technology in digital MacDraw.

Keywords: nano technology, resonant transistor tunnels, quantum cellular automata, semiconductor

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4188 Comparison of Patient Stay at Withy Bush Same Day Emergency Care and Then Those at the Emergency Department

Authors: Joshua W. Edefo, Shafiul Azam, Murray D. Smith

Abstract:

Introduction: In April 2022, the Welsh Government introduced the six goals for urgent and emergency care programs. One of these goals was to provide access to clinically safe alternatives, leading to the establishment of the Same Day Emergency Care (SDEC) program. The SDEC initiative aims to offer viable options that maintain patient safety while avoiding unnecessary hospital stays. The aim of the study is to determine the duration of patient stay in SDEC and compare it with that of Emergency department (ED) stay to ascertain if one of the objectives of SDEC is achieved. Methods: Patient stays and attendance datasets were constructed from Withybush SDEC and ED patient records. These records were provided by Hywel Dda University Health Board Informatics. Some hypothetical pathways were identified, notably SDEC visits involving a single attendance and ED visits then immediately transferred to SDEC. Descriptive statistics were used to summarise the data, and hypothesis tests for mean differences used the student t-test. Propensity scoring was employed to match a set of ED patient stays to SDEC patient stays which were then used to determine the average treatment effect (ATE) to compare durations of stay in SDEC with ED. Regression methods were used to model the natural logarithm of the duration of SDEC attendance, and the level of statistical significance was set to 0.05. Results: SDEC visits involving a single attendance (170 of 384; 44.3%) is the most frequently observed pathway with patient length of stay at 256 minutes (95%CI 237.4 - 275.1). The next most frequently observed pathway of patient stay was SDEC attendance after presenting to ED (80 of 384; 20.8%) and gave the length of stay of 440 minutes (95%CI 351.6 - 529.2). Time spent in this pathway significantly increased by 184 minutes (95%CI 118.0 - 250.2, support for no difference p<0.001) compared to the most seen pathway. When SDEC data were compared with ED, the estimate for the ATE from SDEC single attendance was -272 minutes (95%CI -334.1 - -210.5; p<0.001), while that of ED then SDEC pathway was -50.6 min (95%CI -182.7-81.5; p=0.453). Conclusion: When patients are admitted to SDEC and successfully discharged, their stays are significantly shorter, approximately 4.5 hours, compared to patients who spend their entire stay in the Emergency Department. That difference vanishes when the patient stay includes a period spent previously in ED before transfer to SDEC.

Keywords: attendance, emergency-department, patient-stay, same-day-emergency-care

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4187 Effect of Installation of Long Cylindrical External Store on Performance, Stability, Control and Handling Qualities of Light Transport Aircraft

Authors: Ambuj Srivastava, Narender Singh

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This paper presents the effect of installation of cylindrical external store on the performance, stability, control and handling qualities of light transport category aircraft. A pair of long cylindrical store was installed symmetrically on either side of the fuselage (port and starboard) ahead of the wing and below the fuselage bottom surface running below pilot and co-pilot window. The cylindrical store was installed as hanging from aircraft surface through specially designed brackets. The adjoining structure was sufficiently reinforced for bearing aerodynamic loads. The length to diameter ratio of long cylindrical store was ~20. Based on academic studies and flow simulation analysis, a considerable detrimental effect on single engine second segment climb performance was found which was later validated through extensive flight testing exercise. The methodology of progressive flight envelope opening was adopted. The certification was sought from Regional airworthiness authorities and for according approval.

Keywords: second segment climb, maximum operating speed, cruise performance (single engine and twin engine), minimum control speed, and additional trim required

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4186 Epidemiology of Congenital Heart Defects in Kazakhstan: Data from Unified National Electronic Healthcare System 2014-2020

Authors: Dmitriy Syssoyev, Aslan Seitkamzin, Natalya Lim, Kamilla Mussina, Abduzhappar Gaipov, Dimitri Poddighe, Dinara Galiyeva

Abstract:

Background: Data on the epidemiology of congenital heart defects (CHD) in Kazakhstan is scarce. Therefore, the aim of this study was to describe the incidence, prevalence and all-cause mortality of patients with CHD in Kazakhstan, using national large-scale registry data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2020. Methods: In this retrospective cohort study, the included data pertained to all patients diagnosed with CHD in Kazakhstan and registered in UNEHS between January 2014 and December 2020. CHD was defined based on International Classification of Diseases 10th Revision (ICD-10) codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and the Kaplan-Meier method. Results: In total, 66,512 patients were identified. Among them, 59,534 (89.5%) were diagnosed with a single CHD, while 6,978 (10.5%) had more than two CHDs. The median age at diagnosis was 0.08 years (interquartile range (IQR) 0.01 – 0.66) for people with multiple CHD types and 0.39 years (IQR 0.04 – 8.38) for those with a single CHD type. The most common CHD types were atrial septal defect (ASD) and ventricular septal defect (VSD), accounting for 25.8% and 21.2% of single CHD cases, respectively. The most common multiple types of CHD were ASD with VSD (23.4%), ASD with patent ductus arteriosus (PDA) (19.5%), and VSD with PDA (17.7%). The incidence rate of CHD decreased from 64.6 to 47.1 cases per 100,000 population among men and from 68.7 to 42.4 among women. The prevalence rose from 66.1 to 334.1 cases per 100,000 population among men and from 70.8 to 328.7 among women. Mortality rates showed a slight increase from 3.5 to 4.7 deaths per 100,000 in men and from 2.9 to 3.7 in women. Median follow-up was 5.21 years (IQR 2.47 – 11.69). Male sex (HR 1.60, 95% CI 1.45 - 1.77), having multiple CHDs (HR 2.45, 95% CI 2.01 - 2.97), and living in a rural area (HR 1.32, 95% CI 1.19 - 1.47) were associated with a higher risk of all-cause mortality. Conclusion: The incidence of CHD in Kazakhstan has shown a moderate decrease between 2014 and 2020, while prevalence and mortality have increased. Male sex, multiple CHD types, and rural residence were significantly associated with a higher risk of all-cause mortality.

Keywords: congenital heart defects (CHD), epidemiology, incidence, Kazakhstan, mortality, prevalence

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4185 Efficiently Degradation of Perfluorooctanoic Acid, an Emerging Contaminant, by a Hybrid Process of Membrane Distillation Process and Electro-Fenton

Authors: Afrouz Yousefi, Mohtada Sadrzadeh

Abstract:

The widespread presence of poly- and perfluoroalkyl substances (PFAS) poses a significant concern due to their ability to accumulate in living organisms and their persistence in the environment, thanks to their robust carbon-fluorine (C-F) bonds, which require substantial energy to break (485 kJ/mol). The prevalence of toxic PFAS compounds can be highly detrimental to ecosystems, wildlife, and human health. Ongoing efforts are dedicated to investigating methods for fully breaking down and eliminating PFAS from the environment. Among the various techniques employed, advanced oxidation processes have shown promise in completely breaking down emerging contaminants in wastewater. However, the drawback lies in the relatively slow reaction rates of these processes and the substantial energy input required, which currently impedes their widespread commercial adoption. We developed a hybrid process, comprising electro-Fenton as an advanced oxidation process and membrane distillation, to simultaneously degrade organic PFAS pollutants and extract pure water from the mixture. In this study, environmentally persistent perfluorooctanoic acid (PFOA), as an emerging contaminant, was used to study the effectiveness of the electro-Fenton/membrane distillation hybrid system. The PFOA degradation studies were conducted in two modes: electro-Fenton and electro-Fenton coupled with membrane distillation. High-performance liquid chromatography with ultraviolet detection (HPLC-UV), ion-chromatography (measuring fluoride ion concentration), total organic carbon (TOC) decay, mineralization current efficiency (MCE), and specific energy consumption (SEC) were evaluated for a single EF and hybrid EF-MD processes. In contrast to a single EF reaction, TOC decay improved significantly in the EF-MD process. Overall, the MCE of hybrid processes surpassed 100% while it remained under 50% for a single EF reaction. Calculations of specific energy consumption (SEC) demonstrated a substantial decrease of nearly one-third in energy usage when integrating the EF reaction with the MD process.

Keywords: water treatment, PFAS, membrane distillation, electro-Fenton, advanced oxidation

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4184 Learning and Teaching Strategies in Association with EXE Program for Master Course Students of Yerevan Brusov State University of Languages and Social Sciences

Authors: Susanna Asatryan

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The author will introduce a single module related to English teaching methodology for master course students getting specialization “A Foreign Language Teacher of High Schools And Professional Educational Institutions” of Yerevan Brusov State University of Languages and Social Sciences. The overall aim of the presentation is to introduce learning and teaching strategies within EXE Computer program for Mastery student-teachers of the University. The author will display the advantages of the use of this program. The learners interact with the teacher in the classroom as well as they are provided an opportunity for virtual domain to carry out their learning procedures in association with assessment and self-assessment. So they get integrated into blended learning. As this strategy is in its piloting stage, the author has elaborated a single module, embracing 3 main sections: -Teaching English vocabulary at high school, -Teaching English grammar at high school, and -Teaching English pronunciation at high school. The author will present the above mentioned topics with corresponding sections and subsections. The strong point is that preparing this module we have planned to display it on the blended learning landscape. So for this account working with EXE program is highly effective. As it allows the users to operate several tools for self-learning and self-testing/assessment. The author elaborated 3 single EXE files for each topic. Each file starts with the section’s subject-specific description: - Objectives and Pre-knowledge, followed by the theoretical part. The author associated and flavored her observations with appropriate samples of charts, drawings, diagrams, recordings, video-clips, photos, pictures, etc. to make learning process more effective and enjoyable. Before or after the article the author has downloaded a video clip, related to the current topic. EXE offers a wide range of tools to work out or prepare different activities and exercises for the learners: 'Interactive/non-interactive' and 'Textual/non-textual'. So with the use of these tools Multi-Select, Multi-Choice, Cloze, Drop-Down, Case Study, Gap-Filling, Matching and different other types of activities have been elaborated and submitted to the appropriate sections. The learners task is to prepare themselves for the coming module or seminar, related to teaching methodology of English vocabulary, grammar, and pronunciation. The point is that the teacher has an opportunity for face to face communication, as well as to connect with the learners through the Moodle, or as a single EXE file offer it to the learners for their self-study and self-assessment. As for the students’ feedback –EXE environment also makes it available.

Keywords: blended learning, EXE program, learning/teaching strategies, self-study/assessment, virtual domain,

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4183 Germination Behavior of Tricholaena teneriffae L. a perennial Grass Species

Authors: Imed Mezghani, Yousra Ben Salah, Mohamed Chaieb

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Tricholaena teneriffae L. is a xerophytic perennial herb that belongs to the Poaceae family likely to be used for ecological restoration programs. It's a dominant and economically important species widely distributed in the Bou-Hedma National Park, Tunisia. Reintroduction and expansion of T. teneriffae depend solely on sexual reproduction. This makes the understanding of its germination requirements vital for conservation and management. To provide basic information for its conservation and reintroduction, we studied the influence of environmental factors on seed germination patterns. The germination responses of seeds were determined over a wide range of constant temperatures (15–35°C), polyethylene glycol solutions of different osmotic potentials (0 to −2 MPa) and salt solution (0 to 150 mM of NaCl). Results indicated that the optimum temperature germination was attained at 25°C which corresponds to temperatures prevailing during mid spring season in the Mediterranean area. Seeds germinated in Polyethylene Glycol solutions exhibited significantly lower germination than control especially when water potential fell below -0.6 MPa. Germination percentage and rate decreased with an increase NaCl concentration. Seeds germination was substantially delayed and reduced with an increase in NaCl to levels above 50 mM. T. teneriffae is moderately salt tolerant at germination stage.

Keywords: germination, temperature, Tricholaena teneriffae L., salt stress, water stress, rehabilitation

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4182 The Failure and Energy Mechanism of Rock-Like Material with Single Flaw

Authors: Yu Chen

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This paper investigates the influence of flaw on failure process of rock-like material under uniaxial compression. In laboratory, the uniaxial compression tests of intact specimens and a series of specimens within single flaw were conducted. The inclination angle of flaws includes 0°, 15°, 30°, 45°, 60°, 75° and 90°. Based on the laboratory tests, the corresponding models of numerical simulation were built and loaded in PFC2D. After analysing the crack initiation and failure modes, deformation field, and energy mechanism for both laboratory tests and numerical simulation, it can be concluded that the influence of flaws on the failure process is determined by its inclination. The characteristic stresses increase as flaw angle rising basically. The tensile cracks develop from gentle flaws (α ≤ 30°) and the shear cracks develop from other flaws. The propagation of cracks changes during failure process and the failure mode of a specimen corresponds to the orientation of the flaw. A flaw has significant influence on the transverse deformation field at the middle of the specimen, except the 75° and 90° flaw sample. The input energy, strain energy and dissipation energy of specimens show approximate increase trends with flaw angle rising and it presents large difference on the energy distribution.

Keywords: failure pattern, particle deformation field, energy mechanism, PFC

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4181 Experimental and Theoretical Approach, Hirshfeld Surface, Reduced Density Gradient, Molecular Docking of a Thiourea Derivative

Authors: Noureddine Benharkat, Abdelkader Chouaih, Nourdine Boukabcha

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A thiourea derivative compound was synthesized and subjected to structural analysis using single-crystal X-ray diffraction (XRD). The crystallographic data unveiled its crystallization in the P21/c space group within the monoclinic system. Examination of the dihedral angles indicated a notable non-planar structure. To support and interpret these resulats, density functional theory (DFT) calculations were conducted utilizing the B3LYP functional along with a 6–311 G (d, p) basis set. Additionally, to assess the contribution of intermolecular interactions, Hirshfeld surface analysis and 2D fingerprint plots were employed. Various types of interactions, whether weak intramolecular or intermolecular, within a molecule can significantly impact its stability. The distinctive signature of non-covalent interactions can be detected solely through electron density analysis. The NCI-RDG analysis was employed to investigate both repulsive and attractive van der Waals interactions while also calculating the energies associated with intermolecular interactions and their characteristics. Additionally, a molecular docking study was studied to explain the structure-activity relationship, revealing that the title compound exhibited an affinity energy of -6.8 kcal/mol when docked with B-DNA (1BNA).

Keywords: computational chemistry, density functional theory, crystallography, molecular docking, molecular structure, powder x-ray diffraction, single crystal x-ray diffraction

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4180 Transportation Mode Classification Using GPS Coordinates and Recurrent Neural Networks

Authors: Taylor Kolody, Farkhund Iqbal, Rabia Batool, Benjamin Fung, Mohammed Hussaeni, Saiqa Aleem

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The rising threat of climate change has led to an increase in public awareness and care about our collective and individual environmental impact. A key component of this impact is our use of cars and other polluting forms of transportation, but it is often difficult for an individual to know how severe this impact is. While there are applications that offer this feedback, they require manual entry of what transportation mode was used for a given trip, which can be burdensome. In order to alleviate this shortcoming, a data from the 2016 TRIPlab datasets has been used to train a variety of machine learning models to automatically recognize the mode of transportation. The accuracy of 89.6% is achieved using single deep neural network model with Gated Recurrent Unit (GRU) architecture applied directly to trip data points over 4 primary classes, namely walking, public transit, car, and bike. These results are comparable in accuracy to results achieved by others using ensemble methods and require far less computation when classifying new trips. The lack of trip context data, e.g., bus routes, bike paths, etc., and the need for only a single set of weights make this an appropriate methodology for applications hoping to reach a broad demographic and have responsive feedback.

Keywords: classification, gated recurrent unit, recurrent neural network, transportation

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4179 Research Project of National Interest (PRIN-PNRR) DIVAS: Developing Methods to Assess Tree Vitality after a Wildfire through Analyses of Cambium Sugar Metabolism

Authors: Claudia Cocozza, Niccolò Frassinelli, Enrico Marchi, Cristiano Foderi, Alessandro Bizzarri, Margherita Paladini, Maria Laura Traversi, Eleftherious Touloupakis, Alessio Giovannelli

Abstract:

The development of tools to quickly identify the fate of injured trees after stress is highly relevant when biodiversity restoration of damaged sites is based on nature-based solutions. In this context, an approach to assess irreversible physiological damages within trees could help to support planning management decisions of perturbed sites to restore biodiversity, for the safety of the environment and understanding functionality adjustments of the ecosystems. Tree vitality can be estimated by a series of physiological proxies like cambium activity, starch, and soluble sugars amount in C-sinks whilst the accumulation of ethanol within the cambial cells and phloem is considered an alert of cell death. However, their determination requires time-consuming laboratory protocols, which makes the approach unfeasible as a practical option in the field. The project aims to develop biosensors to assess the concentration of soluble sugars and ethanol in stem tissues. Soluble sugars and ethanol concentrations will be used to define injured trees to discriminate compromised and recovering trees in the forest directly. To reach this goal, we select study sites subjected to prescribed fires or recent wildfires as experimental set-ups. Indeed, in Mediterranean countries, forest fire is a recurrent event that must be considered as a central component of regional and global strategies in forest management and biodiversity restoration programs. A biosensor will be developed through a multistep process related to target analytes characterization, bioreceptor selection, and, finally, calibration/testing of the sensor. To validate biosensor signals, soluble sugars and ethanol will be quantified by HPLC and GC using synthetic media (in lab) and phloem sap (in field) whilst cambium vitality will be assessed by anatomical observations. On burnt trees, the stem growth will be monitored by dendrometers and/or estimated by tree ring analyses, whilst the tree response to past fire events will be assessed by isotopic discrimination. Moreover, the fire characterization and the visual assessment procedure will be used to assign burnt trees to a vitality class. At the end of the project, a well-defined procedure combining biosensor signal and visual assessment will be produced and applied to a study case. The project outcomes and the results obtained will be properly packaged to reach, engage and address the needs of the final users and widely shared with relevant stakeholders involved in the optimal use of biosensors and in the management of post-fire areas. This project was funded by National Recovery and Resilience Plan (NRRP), Mission 4, Component C2, Investment 1.1 - Call for tender No. 1409 of 14 September 2022 – ‘Progetti di Ricerca di Rilevante interesse Nazionale – PRIN’ of Italian Ministry of University and Research funded by the European Union – NextGenerationEU; Grant N° P2022Z5742, CUP B53D23023780001.

Keywords: phloem, scorched crown, conifers, prescribed burning, biosensors

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4178 Characterization of White Spot Lesion Using Focused Ion Beam - Scanning Electron Microscopy

Authors: Malihe Moeinin, Robert Hill, Ferranti Wong

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Background: A white spot lesion (WSL) is defined as subsurface enamel porosity from carious demineralisation on the smooth surfaces of the tooth. It appears as a milky white opacity. Lesions shown an apparently intact surface layer, followed underneath by the more porous lesion body. The small pores within the body of the lesion act as diffusion pathway for both acids and minerals, so allowing the demineralisation of enamel to occur at the advancing front of the lesion. Objectives: The objective is to mapthe porosity and its size on WSL with Focused Ion Bean- Scanning Electron Microscopy (FIB-SEM) Method: The basic method used for FIB-SEM consisted of depositing a one micron thick layer of platinum over 25μmx 25μm of the interest region of enamel. Then, making a rough cut (25μmx 5μmx 20μm) with 3nA current and 30Kv was applied with the help of drift suppression (DS), using a standard “cross-sectional” cutting pattern, which ended at the front of the deposited platinum layer. Two adjacent areas (25μmx 5μmx 20μm) on the both sides of the platinum layer were milled under the same conditions. Subsequent, cleaning cross-sections were applied to polish the sub-surface edge of interest running perpendicular to the surface. The "slice and view" was carried out overnight for milling almost 700 slices with 2Kv and 4nA and taking backscattered (BS) images. Then, images were imported into imageJ and analysed. Results: The prism structure is clearly apparent on FIB-SEM slices of WSL with the dissolution of prism boundaries as well as internal porosity within the prism itself. Porosity scales roughly 100-400nm, which is comparable to the light wavelength (500nm). Conclusion: FIB-SEM is useful to characterize the porosity of WSL and it clearly shows the difference between WSL and normal enamel.

Keywords: white spot lesion, FIB-SEM, enamel porosity, porosity

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4177 A Randomised, Single-Dose, Two-Period, Cross-Over Phase I Pharmacokinetic Study to Compare TDS®-Diazepam with Rectal Diazepam in Healthy Adult Subjects

Authors: Faisal O. Al-Otaibi, Arthur T. Tucker, Richard M. Langford, Stuart Ratcliffe, Atholl Johnston, Terry D. Lee, Kenneth B. Kirby, Chandan A. Alam

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The Transdermal Delivery System (TDS®) is a proprietary liquid formulation that can be applied to intact skin via a metered pump spray to facilitate drug delivery to the circulation. The aim of this study was to assess the ability of the TDS preparation to deliver diazepam systemically, and to characterize the pharmacokinetic profile of the drug in healthy adult subjects. We conducted a randomized, single-dose, two-period, crossover phase I (pharmacokinetic) comparative study in twelve healthy volunteers. All volunteers received both 10 mg TDS-diazepam topically to the upper chest and 10 mg of the rectal diazepam preparation (Diastat®, 10 mg diazepam gel), with a minimum washout of 14 days between dosing episodes. Both formulations were well tolerated in all volunteers. Following topical application of TDS-diazepam, the mean AUC0-72h was 1241 ng/mL.h and the Cmax 34 ng/mL. The values for rectal Diastat were 4109 ng/mL.h and 300 ng/mL respectively. This proof of concept study demonstrates that the TDS preparation successfully delivered diazepam systemically to adults. As expected, the concentration of diazepam following the TDS application was lower and not bioequivalent to rectal gel. Future development of this unique system is required.

Keywords: transdermal delivery system, diazepam, seizure, bioequivalence, pharmacokinetic

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4176 The Effectiveness of the Workers' Constitutional Rights of Citizenship as One of the Embodiments of the Democratic and Social State of the Brazilian Law

Authors: Christine S. Veviani

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By observing the Brazilian labor reality, considered as degrading and oppressive, as well as responsible for creating obstacles to rights, this paper is aimed at demonstrating the obligatoriness of complying with the Constitution, as an effective instrument of the Democratic and Social State of Law established in the country since 1988, which identifies and determines the recognition of a single type of citizenship, as representation of equality, social inclusion and human dignity. To achieve this purpose, that is, to awake to a new culture focused on human respect / fundamental rights engraved in the Brazilian Constitution, doctrinal works, case law and labor courts (how they work) will be used as methodology. Thus, by concluding that there is a need for a change in behavior, by employers, intended to respect the Constitution, especially with regard to the concept and citizenship content if an attempt is made to achieve as a result few steps effectiveness of fundamental social rights protective of the Brazilian working class. Thus, by analyzing the Brazilian labor reality, the result is the employers' denial of full and single citizenship of workers, whose effects are directly related to the violation of rights, which leads to the conclusion that there is a need for a change in the behavior regarding the respect for the Constitution, especially concerning the effectiveness of fundamental social rights, which protect the working class in Brazil.

Keywords: employment relationships, opposing citizenships, constitutionalism, capitalism

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4175 Effects of Blast Load on Historic Stone Masonry Buildings in Canada: A Review and Analytical Study

Authors: Abass Braimah, Maha Hussein Abdallah

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The global ascendancy of terrorist attacks on building infrastructure with economic and heritage significance has increased awareness of the possibility of terrorism in Canada. Many structures in Canada that are at risk of terrorist attacks include government buildings, built many years ago of historic stone masonry construction. Although many researchers are investigating ways to retrofit masonry stone buildings to mitigate the effect of blast loadings, lack of knowledge on the dynamic behavior of historic stone masonry structures under blast loads makes it difficult to ascertain the effectiveness of the retrofitting techniques. This paper presents a review of open-source literature for the experimental and numerical stone masonry structures under blast loads. This review yielded very little information of the response of the historic stone masonry structures under blast loads. Thus, a comprehensive study is needed to understand the blast load effects on historic stone masonry buildings. The out-of-plane response of historic masonry structures to blast loads is investigated by using single-degree-of-freedom analysis. This approach presents equations that can be used effectively in the analysis of historic masonry walls to out-of-plane blast loading.

Keywords: blast loads, historical buildings, masonry structure, single-degree-of-freedom analysis

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4174 Prevalence and Characteristics of Torus Palatinus among Western Indonesian Population

Authors: Raka Aldy Nugraha, Kiwah Andanni, Aditya Indra Pratama, Aswin Guntara

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Background: Torus palatinus is a bony protuberance in the hard palate. Sex and race are considered as influencing factors for the development of torus palatinus. Hence, the objective of this study was to determine the prevalence and characteristics of torus palatinus and its correlation with sex and ethnicity among Western Indonesian Population. Methods: We conducted a descriptive and analytical study employing cross-sectional design in 274 new students of Universitas Indonesia. Data were collected by using consecutive sampling method through questionnaire-filling and direct oral examination. Subject with racial background other than indigenous Indonesian Mongol were excluded from this study. Data were statistically analyzed using chi square test for categorical variables whereas logistic regression model was employed to assess the correlation between variables of interest with prevalence of torus palatinus. Results: Torus palatinus were found in 212 subjects (77.4%), mostly small in size (< 3 mm) and single in number, with percentage of 50.5% and 90.6%, respectively. The prevalence of torus palatinus were significantly higher in women (OR 2.88; 95% CI: 1.53-5.39; p = 0.001), dominated by medium-sized and single tori. There was no significant correlation between ethnicity and the occurrence of torus palatinus among Western Indonesian population. Conclusion: Torus palatinus was prevalent among Western Indonesian population. It showed significant positive correlation with sex, but not with ethnicity.

Keywords: characteristic, ethnicity, Indonesia, mongoloid, prevalence, sex, Torus palatinus

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4173 An Adaptive Application of Emotionally Focused Couple Therapy with Trans and Nonbinary Couples

Authors: Reihaneh Mahdavishahri, Dumayi Gutierrez

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Emotionally focused couple therapy (EFCT) is one of the most effective and evidence-based approaches to couple therapy. Yet, literature is scarce of its effective application with trans and non-binary couples. It is estimated that 1.4 million trans adults live in the United Stated, with about 40% of these individuals experiencing serious psychological distress within the past month. Trans and nonbinary adults are significantly likely to experience discrimination, harassment, family rejection, and relationship challenges throughout the course of their lives. As systemic therapists, applying an informed lens when working with trans and nonbinary couples can contribute to providing effective mental health care to these individuals. This paper aims to provide a comprehensive, intersectional, and culturally informed application of EFCT with trans and nonbinary couples. We will address the current literature on applications of EFCT with diverse couples, EFCT’s strengths and limitations on cultural humility, and the gaps within current systems of care for trans and nonbinary couples. We will then provide an adaptive application of EFCT to help trans, and nonbinary couples recover from potential attachment injuries in their relationships, intersecting gender minority stressors, and achieve healing and restoration in their interpersonal dynamics.

Keywords: attachment, culturally informed care, emotionally focused couple therapy, trans and nonbinary couples

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